Home Country Coverage

Home Country Coverage (If Benefit is Purchased) – The Home Country Coverage provides limited coverage under your Medical Expense Benefit while in your Home Country. The plan pays 80% up to $5,000 of Eligible Expenses, then 100% to a maximum of 1) $50,000 for Incidental Trip(s) to your Home Country or 2) $10,000 for Extension of Benefits (Follow Me Home Coverage).

1) Incidental Trip(s) to your Home Country: During the period of coverage, You may return to Your Home Country for incidental visits of up to 60 days per 12 months of coverage, or pro rata there of (approximately 5 days per month of purchased coverage). If during an incidental trip home, You suffer an Injury or Sickness, this Plan will pay up to $50,000 of Eligible Expenses.

2) Extension of Benefits (Follow Me Home Coverage): This plan will pay up to a maximum of $10,000 for Eligible Expenses incurred in Your Home Country related to an Injury or Sickness which originally occurred, was diagnosed and treated outside Your Home Country during Your period of coverage.

Home Country Coverage (If Benefit is Purchased):

The Home Country Coverage provides limited coverage under your Medical Expense Benefit while in your Home Country. The plan pays 80% up to $5,000 of Eligible Expenses, then 100% to a maximum of 1) $50,000 for Incidental Trip(s) to your Home Country or 2) $10,000 for Extension of Benefits (Follow Me Home Coverage).

1) Incidental Trip(s) to your Home Country: During the period of coverage, You may return to Your Home Country for incidental visits of up to 60 days per 12 months of coverage, or pro rata thereof (approximately 5 days per month of purchased coverage). If during an incidental trip home, You suffer an Injury or Sickness, this Plan will pay up to $50,000 of Eligible Expenses.

2) Extension of Benefits (Follow Me Home Coverage): This plan will pay up to a maximum of $10,000 for Eligible Expenses incurred in Your Home Country related to an Injury or Sickness which originally occurred, was diagnosed and treated outside Your Home Country during Your period of coverage.

Home Country Coverage (If Benefit is Purchased):

The Home Country Coverage provides limited coverage under your Medical Expense Benefit while in your Home Country. The plan pays 80% up to $5,000 of Eligible Expenses, then 100% to a maximum of 1) $50,000 for Incidental Trip(s) to your Home Country or 2) $10,000 for Extension of Benefits (Follow Me Home Coverage).

1) Incidental Trip(s) to your Home Country: During the period of coverage, You may return to Your Home Country for incidental visits of up to 60 days per 12 months of coverage, or pro rata thereof (approximately 5 days per month of purchased coverage). If during an incidental trip home, You suffer an Injury or Sickness, this Plan will pay up to $50,000 of Eligible Expenses.

2) Extension of Benefits (Follow Me Home Coverage): This plan will pay up to a maximum of $10,000 for Eligible Expenses incurred in Your Home Country related to an Injury or Sickness which originally occurred, was diagnosed and treated outside Your Home Country during Your period of coverage.

P. INCIDENTAL TRIP:

As an accommodation and supplemental benefit and subject to the Terms of this insurance, the Insured Person will be covered under this insurance during incidental return trips to their Country of Residence up to the number of days shown in the BENEFIT SUMMARY during the Period of Coverage beginning with the date the Insured Person first arrives back in their Country of Residence provided that:

(1) the Insured Person has departed their Country of Residence prior to any Incidental Trip

(2) the Insured Person has timely paid applicable Premium for at least thirty (30) days of continuous coverage

(3) the Country of Residence is not the United States

(4) the intention or purpose of the Insured Person’s return trip to the Country of Residence is not to receive Treatment for an Illness or Injury incurred or sustained while traveling outside of their Country of Residence

(5) the Insured Person’s return trip to the Country of Residence does not result in receiving Treatment for an Illness or Injury incurred or sustained while traveling outside of their Country of Residence.

P. INCIDENTAL TRIP:

As an accommodation and supplemental benefit and subject to the Terms of this insurance, the Insured Person will be covered under this insurance during incidental return trips to their Country of Residence up to the number of days shown in the BENEFIT SUMMARY during the Period of Coverage beginning with the date the Insured Person first arrives back in their Country of Residence provided that:

(1) the Insured Person has departed their Country of Residence prior to any Incidental Trip

(2) the Insured Person has timely paid applicable Premium for at least thirty (30) days of continuous coverage

(3) the Country of Residence is not the United States

(4) the intention or purpose of the Insured Person’s return trip to the Country of Residence is not to receive Treatment for an Illness or Injury incurred or sustained while traveling outside of their Country of Residence

(5) the Insured Person’s return trip to the Country of Residence does not result in receiving Treatment for an Illness or Injury incurred or sustained while traveling outside of their Country of Residence.

O. INCIDENTAL TRIP:

As an accommodation and supplemental benefit and subject to the Terms of this insurance, the Insured Person will be covered under this insurance during incidental return trips to their Country of Residence up to the number of days shown in the BENEFIT SUMMARY during the Period of Coverage beginning with the date the Insured Person first arrives back in their Country of Residence provided that:

(1) the Insured Person has departed their Country of Residence prior to any Incidental Trip

(2) the Insured Person has timely paid applicable Premium for at least thirty (30) days of continuous coverage

(3) the Country of Residence is not the United States

(4) the intention or purpose of the Insured Person’s return trip to the Country of Residence is not to receive Treatment for an Illness or Injury incurred or sustained while traveling outside of their Country of Residence

(5) the Insured Person’s return trip to the Country of Residence does not result in receiving Treatment for an Illness or Injury incurred or sustained while traveling outside of their Country of Residence.

N. EMERGENCY TREATMENT WHILE TRAVELING THROUGH THE UNITED STATES:

As an accommodation and supplemental benefit, the Insured Person will be covered under this insurance within the United States for incidental Emergency Treatment up to the number of days and Maximum Limit shown in the BENEFIT SUMMARY, provided that:

(1) the Insured Person was traveling through the United States en route to or from a Destination Country

(2) the United States is not one of the Insured Person’s Destination Countries

(3) the Insured Person requires Treatment for an Injury or Illness that is an Emergency

(4) Treatment for an Injury or Illness that is an Emergency must be Pre-certified and coordinated by the Company

O. EMERGENCY MEDICAL EVACUATION TO THE UNITED STATES AND ASSOCIATED TREATMENT:

When an Insured Person has received Emergency Medical Evacuation to the United States by the Company, the Insured Person will be covered for Eligible Medical Expenses incurred for up to the number of days and Maximum Limit shown in the BENEFIT
SUMMARY, provided that:

(1) the Emergency Medical Evacuation and medical Facility must be Pre-certified and coordinated by the Company

(2) the Insured Person shall have no coverage in the United States beyond the Maximum Limit shown in the BENEFIT SUMMARY

(3) the Insured Person’s coverage under this insurance shall continue if and when the Insured Person returns to the Destination Country during the Period of Coverage.

P. EMERGENCY TREATMENT DURING INCIDENTAL TRIP TO COUNTRY OF RESIDENCE:

As an accommodation and supplemental benefit and subject to the Terms of this insurance, the Insured Person will be covered under this insurance during incidental return trips to their Country of Residence up to the number of days and Maximum Limit shown in the BENEFIT SUMMARY during the Period of Coverage beginning with the date the Insured Person first arrives back in their Country of Residence provided that:

(1) the Insured Person has departed their Country of Residence prior to any incidental trip

(2) the Insured Person has timely paid applicable Premium for at least thirty (30) days of continuous coverage

(3) Treatment for an Illness or Injury must have not incurred or been sustained while in the Destination Country

(4) Treatment must be Pre-certified and coordinated by the Company.

Combined Maximum Limit: $50,000, Maximum consecutive days: 14

N. EMERGENCY TREATMENT WHILE TRAVELING THROUGH THE UNITED STATES:

As an accommodation and supplemental benefit, the Insured Person will be covered under this insurance within the United States for incidental Emergency Treatment up to the number of days and Maximum Limit shown in the BENEFIT SUMMARY, provided that:

(1) the Insured Person was traveling through the United States en route to or from a Destination Country

(2) the United States is not one of the Insured Person’s Destination Countries

(3) the Insured Person requires Treatment for an Injury or Illness that is an Emergency

(4) Treatment for an Injury or Illness that is an Emergency must be Pre-certified and coordinated by the Company

O. EMERGENCY MEDICAL EVACUATION TO THE UNITED STATES AND ASSOCIATED TREATMENT:

When an Insured Person has received Emergency Medical Evacuation to the United States by the Company, the Insured Person will be covered for Eligible Medical Expenses incurred for up to the number of days and Maximum Limit shown in the BENEFIT SUMMARY, provided that:

(1) the Emergency Medical Evacuation and medical Facility must be Pre-certified and coordinated by the Company

(2) the Insured Person shall have no coverage in the United States beyond the Maximum Limit shown in the BENEFIT SUMMARY

(3) the Insured Person’s coverage under this insurance shall continue if and when the Insured Person returns to the Destination Country during the Period of Coverage.

P. EMERGENCY TREATMENT DURING INCIDENTAL TRIP TO COUNTRY OF RESIDENCE:

As an accommodation and supplemental benefit and subject to the Terms of this insurance, the Insured Person will be covered under this insurance during incidental return trips to their Country of Residence up to the number of days and Maximum Limit shown in the BENEFIT SUMMARY during the Period of Coverage beginning with the date the Insured Person first arrives back in their Country of Residence provided that:

(1) the Insured Person has departed their Country of Residence prior to any incidental trip

(2) the Insured Person has timely paid applicable Premium for at least thirty (30) days of continuous coverage

(3) Treatment for an Illness or Injury must have not incurred or been sustained while in the Destination Country

(4) Treatment must be Pre-certified and coordinated by the Company.

3.5 Incidental Trips to Home Country

If the Period of Coverage is greater than thirty (30) days, the Company will reimburse You for Covered Expenses up to the amount set forth in the Schedule of Benefits for a new covered Injury or Illness that begins while You are on an incidental trip to Your Home Country. You must first depart Your Home Country before utilizing this benefit, and it does not apply to the final trip to Your Home Country. You may be required to provide proof of Your travel intentions. Additionally, this coverage will not apply (i) if the Illness began or Injury occurred while You were outside Your Home Country or (ii) for Pre-Existing Conditions, including Acute Onset of a Pre-existing Condition(s).

The Deductible, Copay and Coinsurance options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

The limit for this coverage is the amount shown on the Schedule of Benefits under “Incidental Trips to Home Country,” not the amount shown for “Medical Maximum Options.”

3.5 Incidental Trips to Home Country

If the Period of Coverage is greater than thirty (30) days, the Company will reimburse You for Covered Expenses up to the amount set forth in the Schedule of Benefits for a new covered Injury or Illness that begins while You are on an incidental trip to Your Home Country. You must first depart Your Home Country before utilizing this benefit, and it does not apply to the final trip to Your Home Country. You may be required to provide proof of your travel intentions. Additionally, this coverage will not apply (i) if the Illness began or Injury occurred while You were outside Your Home Country or (ii) for Pre‐Existing Conditions.

Under this section, You will receive five (5) days of coverage per month of coverage purchased up to a maximum of sixty (60) days per three hundred sixty‐four (364) days of purchased coverage. The Deductible options set forth in Section 3.1 apply to this coverage and will be Your responsibility, additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

The limit for this coverage is that amount shown on the Schedule of Benefits under “Incidental Trips to Home Country,” not the amount shown for “Medical Maximum Options.”

3.6 Incidental Trips to Home Country.

If the Period of Coverage is greater than thirty (30) days, the Company will reimburse You for Covered Expenses up to the amount set forth in the Schedule of Benefits for a new covered Injury or Illness that begins while You are on an incidental trip to Your Home Country. You must first depart Your Home Country before utilizing this benefit, and it does not apply to the final trip to Your Home Country. You may be required to provide proof of your travel intentions. Additionally, this coverage will not apply (i) if the Illness began or Injury occurred while You were outside Your Home Country or (ii) for Pre-Existing Conditions.

Under this section, You will receive five (5) days of coverage per month of coverage purchased up to a maximum of sixty (60) days per three hundred sixty-four (364) days of purchased coverage.

The Deductible options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section.

The limit for this coverage is that amount shown on the Schedule of Benefits under “Incidental Trips to Home Country,” not the amount shown for “Medical Maximum Options.”

3.5 Incidental Trips to Home Country.

If the Period of Coverage is greater than thirty (30) days, the Company will reimburse You for Covered Expenses up to the amount set forth in the Schedule of Benefits for a new covered Injury or Illness that begins while You are on an incidental trip to Your Home Country. You must first depart Your Home Country before utilizing this benefit, and it does not apply to the final trip to Your Home Country. You may be required to provide proof of Your travel intentions. Additionally, this coverage will not apply (i) if the Illness began or Injury occurred while You were outside Your Home Country or (ii) for Pre-Existing Conditions, including Acute Onset of a Pre-existing Condition(s).

Under this section, You will receive five (5) days of coverage per month of coverage purchased up to a maximum of sixty (60) days per three hundred sixty-four (364) days of purchased coverage.

The Deductible, Copay and Coinsurance options set forth in Section 3.1 apply to this coverage and will be Your responsibility. Additionally, the exclusions set forth in Section 8 apply to the coverage provided by the Certificate under this section

The limit for this coverage is the amount shown on the Schedule of Benefits under “Incidental Trips to Home Country,” not the amount shown for “Medical Maximum Options.”

OPTIONAL RETURN TO HOME COUNTRY

If Coverage is purchased, the Covered Person may return to their Home Country for up to 60 days per 12 months of Coverage Purchased during the Policy Period for an Incidental Trip. If a Covered Injury or Illness occurs while on their Incidental Trip, this benefit will pay to the maximum as outlined in the Schedule of Benefits for covered medical expenses incurred during the Incidental Trip. To be eligible for an Incidental Trip the Covered Person’s Policy Period must be greater than 30 days in length. If the Covered Person does not return from their Incidental Trip on their scheduled return date, the Policy will be Terminated on the date of their scheduled return from their Home Country.

If the Covered Person’s scheduled return date cannot be verified, the Policy will terminate on their date the Covered Person departed for their Home Country. Any Injury or Illness that occurred during the Incidental Trip will be considered a Pre-Existing Condition once the Incidental Trip has concluded and no further expenses for that Injury or Illness will be covered.

Benefit Period & Home Country Coverage

Benefit Period

While the certificate is in effect, the benefit period does not apply. Upon termination of the certificate, including when you return to your home country, the benefit period applies for up to 90 days only to eligible medical expenses directly related to an injury or illness that was diagnosed or treated while the certificate was in effect. The benefit period begins on the first day of diagnosis or treatment of a covered injury or illness made while you are outside your home country. The benefit period applies whether or not you return to your home country.

Incidental Home Country Coverage

You must have purchased three months of coverage for the Incidental Home Country Coverage to be in effect.

U.S. home country: For every three-month period during which you are covered, eligible medical expenses incurred in the U.S. are covered up to a maximum of 15 days.

Non-U.S. home country: For every three-month period during which you are covered, eligible medical expenses incurred in your home country are covered up to a maximum of 30 days.

Should you make a change to the location of your home country during the certificate period, you must notify us of such change within fifteen (15) days. Your new home country will govern the terms of any home country or incidental home country coverage.

Any benefit accrued under a single three-month period does not accumulate to another period. Failure to continue your international trip or your return to your home country for the sole purpose of obtaining treatment for an illness or injury that began while traveling shall void any incidental home country coverage.

Except for a benefit period, coverage provided under this Master Policy is for a maximum duration of 365 days for non-U.S. citizens or residents whose travel does not include the U.S. or U.S. Territories, and for all other members, the maximum certificate period is 364 days. Any extension of coverage is based upon the eligibility rules in force and is solely at our discretion.

Notwithstanding the foregoing, coverage under all plans shall terminate on the date we, at our sole option, elect to cancel all members of the same sex, age, class or geographic location, provided we give no less than 30 days advance written notice by mail to your last known address.

BENEFIT PERIOD & HOME COUNTRY COVERAGE

Benefit Period

While the certificate is in effect, the benefit period does not apply. Upon termination of the certificate, including when you return to your home country, the benefit period applies for up to 90 days only to eligible medical expenses directly related to an injury or illness that was diagnosed or treated while the certificate was in effect. The benefit period begins on the first day of diagnosis or treatment of a covered injury or illness made while you are outside your home country. The benefit period applies whether or not you return to your home country.

INCIDENTAL HOME COUNTRY COVERAGE

You must have purchased three months of coverage for the Incidental Home Country Coverage to be in effect.

U.S. home country: For every three-month period during which you are covered, eligible medical expenses incurred in the U.S. are covered up to a maximum of 15 days.

Non-U.S. home country: For every three-month period during which you are covered, eligible medical expenses incurred in your home country are covered up to a maximum of 30 days.

Should you make a change to the location of your home country during the certificate period, you must notify us of such change within fifteen (15) days. Your new home country will govern the terms of any home country or incidental home country coverage.

Any benefit accrued under a single three-month period does not accumulate to another period. Failure to continue your international trip or your return to your home country for the sole purpose of obtaining treatment for an illness or injury that began while traveling shall void any incidental home country coverage.

HOME COUNTRY COVERAGE

BENEFIT PERIOD

While the certificate is in effect, the benefit period does not apply. Upon termination of the certificate, including when you return to your home country, the benefit period applies for up to 90 days only to eligible medical expenses directly related to an injury or illness that was diagnosed or treated while the certificate was in effect. The benefit period begins on the first day of diagnosis or treatment of a covered injury or illness made while you are outside your home country. The benefit period applies whether or not you return to your home country.

INCIDENTAL HOME COUNTRY COVERAGE

You must have purchased three months of coverage for the Incidental Home Country Coverage to be in effect.

U.S. home country: For every three-month period during which you are covered, eligible medical expenses incurred in the U.S. are covered up to a maximum of 15 days.

Non-U.S. home country: For every three-month period during which you are covered, eligible medical expenses incurred in your home country are covered up to a maximum of 30 days.

Should you make a change to the location of your home country during the certificate period, you must notify us of such change within fifteen (15) days. Your new home country will govern the terms of any home country or incidental home country coverage

Any benefit accrued under a single three-month period does not accumulate to another period. Failure to continue your international trip or your return to your home country for the sole purpose of obtaining treatment for an illness or injury that began while traveling shall void any incidental home country coverage.

HOME COUNTRY COVERAGE

BENEFIT PERIOD

While the certificate is in effect, the benefit period does not apply. Upon termination of the certificate, including when you return to your home country, the benefit period applies for up to 90 days only to eligible medical expenses directly related to an injury or illness that was diagnosed or treated while the certificate was in effect. The benefit period begins on the first day of diagnosis or treatment of a covered injury or illness made while you are outside your home country. The benefit period applies whether or not you return to your home country.

INCIDENTAL HOME COUNTRY COVERAGE

You must have purchased three months of coverage for the Incidental Home Country Coverage to be in effect.

U.S. home country: For every three-month period during which you are covered, eligible medical expenses incurred in the U.S. are covered up to a maximum of 15 days.

Non-U.S. home country: For every three-month period during which you are covered, eligible medical expenses incurred in your home country are covered up to a maximum of 30 days.

Should you make a change to the location of your home country during the certificate period, you must notify us of such change within fifteen (15) days. Your new home country will govern the terms of any home country or incidental home country coverage.

Any benefit accrued under a single three-month period does not accumulate to another period. Failure to continue your international trip or your return to your home country for the sole purpose of obtaining treatment for an illness or injury that began while traveling shall void any incidental home country coverage.